This invention relates to a suturing instrument with which to arrest hemorrhaging or to suture or anastomose the tissue in the lumen using a flexible endoscope.
In recent years, there has been remarkable progress in the development of suturing instruments with which to suture the tissue in the lumen or hemostasis site. In particular, the development of suturing instruments applicable to open surgery and bellybutton surgery, in which the operation is performed through several fistulas created in the abdomen, has been attempted through several experiments.
For example, U.S. Pat. No. 6,086,601 (InBae Yoon) is a surgical suturing instrument intended for application to open surgery or bellybutton surgery. It consists of a needle driver that rotates freely in a rigid barrel and a needle catcher, which are operated with handles mounted on the main body at its proximal end. A needle with thread is delivered and held alternately between them to suture the tissue.
As another example, U.S. Pat. No. 4,484,580 (Janome Sewing Machine Co.) is a surgical suturing instrument intended for application to open surgery or belly button surgery. It consists of a curved needle, which has a needle eye and an oblong groove, and which is fixed to a needle bar and a shuttle thread connected through the needle eye and oblong groove to a shuttle which is fixed between a shuttle claw and a shuttle holder of a shuttle holder member. The suturing procedure is as follows: The tissue is punctured by the curved needle through the needle bar. The shuttle thread coming out of the tissue forms a loop of a crescent. Then the shuttle is wound around the loop of crescent by the shuttle holder member to form a stitch.
However, as U.S. Pat. No. 6,086,601 (InBae Yoon) was originally intended for use in open surgery or bellybutton surgery, it cannot be used in conjunction with an endoscope, which bends flexibly so as to be inserted into digestive organs. Even if the needle driver or other driving shaft is replaced by a flexible wire so as to make it applicable to a flexible endoscope, the force with which the needle driver grasps the needle is so weak that the needle may easily fall off from the needle driver when puncturing, causing the puncture to fail. In addition, every time the needle is delivered from the needle driver to the needle catcher for a stitch, it must be returned from the needle catcher to the needle driver. This requires a complicated operation. Moreover, to deliver the needle between the needle driver and the needle catcher in a limited range, they must be rotated many times to adjust for the difference in their loci. This takes a lot of time.
Similarly, as in U.S. Pat. No. 6,086,601 (InBae Yoon), U.S. Pat. No. 4,484,580 (Janome Sewing Machine Co.) was developed for use in open surgery or bellybutton surgery and cannot be used in conjunction with an endoscope, which bends flexibly so as to be inserted into digestive organs. In addition, as in U.S. Pat. No. 6,086,601 (InBae Yoon), even if the needle bar or the rod portion of U.S. Pat. No. 4,484,580 (Janome Sewing Machine Co.) is replaced with a flexible coil, it will not work because a shuttle thread long enough to perform continuous stitches must be laid along the shuttle and the curved needle, causing the shuttle thread to be seen in the view field or disturbing the curved needle at the time of puncture. Moreover, it can be very poor in suture efficiency or even make suture work itself impossible because it is very difficult to thrust the curved needle through the tissue in actual practice, as shown with respect to curved needle 300 and tissue 301 in FIG. 43. The practice, as shown in FIG. 5 in the specification of U.S. Pat. No. 4,484,580 (Janome Sewing Machine Co.), cannot be realized without the tissue in the vicinity of the part being held tight.